How We Bring You Relief from a Painful Pilonidal Cyst

You’ve developed a small but painful, pimple-like bump at the top of the cleft in your bottom, just below your tailbone. Despite its small size, the lump is causing large problems as you're finding it painful to sit or lie down on your back.

Called a pilonidal cyst, these fluid- or air-filled sacs are not uncommon — they affect about 70,000 people in the United States each year.

The good news when it comes to pilonidal cysts is that the team here at Fairfax Colon & Rectal Surgery can bring you relief through a quick, in-office procedure.

Below, we take a look at where these pesky lumps come from and how we can make quick work of your pilonidal cyst, allowing you to sit and lie down without pain again.

Behind your pilonidal cyst

A pilonidal cyst is an infection in your skin that researchers believe is created when a hair grows inward or sideways. Your body views this odd growth as an invasion and responds by launching a defense. As a result, the cyst can fill with pus as infection sets in, and thickened tissue can develop in the area.

The longer the skin infection goes untreated, the more your chances increase for a painful abscess or the formation of a sinus cavity (empty space) just below your skin. These empty spaces are an invitation for future problems, so we want to avoid them.

Pilonidal cysts occur much more frequently in men — men are more than two times more likely to have them than women — and this may be attributable to coarser body hair.

Outside of gender, another risk factor for pilonidal cysts is prolonged sitting, which is why the condition earned the nickname Jeep driver’s disease during World War II. 

How we treat pilonidal cysts

No matter how you developed a pilonidal cyst, we want you to know that it’s not likely that the condition is going to get better on its own. Also, the sooner we intervene, the easier the procedure and the faster you can get to a favorable outcome.

In the early stages of a painful pilonidal cyst, all it takes is a quick visit to our office for an incision and drainage procedure. First, we administer a local anesthetic for your comfort and then we make a small incision to drain the cyst. Then, we pack the remaining hole with gauze to encourage healing from the inside out.

If the cyst returns or you’ve developed an abscess or large sinus cavity, we may have to perform slightly more extensive work. We can still accomplish this with an in-office procedure, during which we make a larger incision to remove the entire cyst and some surrounding tissues.

Also called a cystectomy, we pack the area with gauze after the procedure so that the edges don’t reconnect too soon, which can impede the healing below.

Whether we perform a simple incision and drainage or a cystectomy, you should count on a few weeks of recovery time (longer for the cystectomy). During this time, you’ll need to take care when sitting (a donut pillow is helpful) and follow our aftercare instructions, which are designed to prevent the infection from returning.

Between our work and your care and patience, you should find much-needed relief from your painful pilonidal cyst in no time.

If you’d like to figure out which approach is best for your pilonidal cyst, please contact one of our offices in Fairfax, Fair Oaks, Alexandria, Gainesville, Woodbridge, or Lansdowne, Virginia, to schedule an appointment.